a doctor who has the primary responsibility for coordinating the medical care for a patient. In the

NICU this will generally be the neonatologist.

BAGGING

Filling the lungs with air or oxygen by squeezing a bag which is connected to an endotracheal tube or attached to a mask fitted over the face. This allows us to breathe for the baby when his own breaths are not enough.

BILILIGHTS (Phototherapy)

special lights used in the treatment of jaundice; see JAUNDICE.

BILIRUBIN

A breakdown product of red blood cells. See JAUNDICE.

BLOOD GASES

The amounts of oxygen, carbon dioxide and degree of acidity in the blood. A small amount of blood is taken from the heel (by heel stick), umbilical catheter or from the artery near the wrist where your pulse is felt to test for these levels.

BLOOD PRESSURE (BP)

The pressure of the blood in the arteries with each pulsation of the heart.

BRADYCARDIA

An abnormally slow heart rate.

BROVIAC

see CENTRAL CATHETER

CARDIOLOGIST

A medical doctor who specializes in the heart and circulation.

CASE MANAGER

A staff member who interfaces with insurance agencies regarding medical necessity and length of stay, as required, helps with discharge planning, arranging for medical equipment and visiting nurses when necessary, and makes referrals to CCS for medically eligible infants. Many insurance companies also have CASE MANAGERS who are assigned to customize and individualize benefits for those with extensive or complex health care needs.

CBC (Complete Blood Count)

A count of the various types of cells present in the blood, chiefly: red cells (for carrying oxygen), white cells (for fighting infection), and platelets (for prevention of bleeding).

CCS (California Children's Services)

a state agency, operating by county, which assists with medical benefits and ongoing therapies for infants and children who meet certain diagnostic criteria.

CENTRAL CATHETER or CENTRAL LINE

a thin, flexible tube (catheter) placed in a larger vein or artery to deliver medications or necessary fluids and nutrients to the body. Broviac catheters are usually placed in the upper chest and tunnel under the skin to enter the vena cava, the large blood vessel in the center of the body carrying blood to the heart. PICC lines (percutaneously inserted central catheters) are usually threaded through a vein in the arm to the vena cava. Central catheters also include umbilical venous and umbilical artery catheters which may be inserted into the vein or artery of the umbilical stump (belly button) shortly after birth.

CHEMSTRIP

a test in which a drop of the baby's blood is placed on a strip of special paper to determine the amount of sugar in the blood.

CHEST TUBE

A small plastic tube placed through the chest wall into the space between the lung and chest wall to remove air or fluid from this space. See PNEUMOTHORAX.

CIRCUMCISION

A surgical procedure done to remove the foreskin of the penis. Usually done just before the baby goes home and only on request.

CONGENITAL

Existing at the time of birth.

CPAP

Continuous Positive Airway Pressure - a form of ventilator assistance which helps to keep the baby's lungs properly expanded. CPAP does not breathe for the baby, but allows the baby to breathe into a "wind."

CT SCAN (of the head)

Computerized x-rays which show the size and position of many parts of the brain. A CT scan also can be done on other parts of the body. The baby must go to another area of the hospital to have a CT scan.

CULTURE

A laboratory test of blood, spinal fluid, urine, or other specimens which shows if germs are present and which ones they are.

CYANOSIS

Blue color of the skin occurring when there is not enough oxygen in the blood.

DIFFERENTIAL

A test which divides the white blood cell count (from the CBC) into several categories, chiefly: "polys" (short for polymorphonuclear leukocytes), "bands" (immature "polys"), "lymphs" (lymphocytes), "monos" (monocytes), "cos" (eosinophils), "basos" (basophils). The percentages of each cell type may vary in different kinds of infections; for example, polys and bands usually will predominate in bacterial infections, while the number of lymphs usually will increase in viral infections.

ECHOCARDIOGRAM

A test done to look at the heart using soundwaves through the chest wall. This is much like an ultrasound done during pregnancy and is neither harmful nor painful.

EDEMA

"Puffy" skin from a build-up of fluid in body tissues.

ENDOTRACHEAL TUBE (ET Tube)

A plastic tube which goes from the baby's nose or mouth past the vocal cords and into the upper trachea (windpipe).

EXCHANGE TRANSFUSION

A treatment which removes the baby's blood in small quantities and replaces it with donor blood. This procedure is used most frequently to lower the level of bilirubin in the baby's blood. (See also Jaundice.) It also may be used to raise or lower the number of red blood cells, and improve the ability of the blood to clot.

EXTUBATION

removal of a tube which has been placed through the nose or mouth into the trachea; see

ENDOTRACHEAL TUBE.

FELLOW (in Neonatology)

A trained pediatrician who is receiving additional specialized training in the care of sick newborns.

GASTROENTEROLOGIST

a medical doctor who specializes in the digestive system.

GASTROSTOMY

a surgically created opening in the abdominal wall to provide nutrition directly into the stomach.

GAVAGE FEEDINGS

Feedings delivered by a small plastic tube placed through the nose or mouth and down into the

stomach when the baby is too weak or too premature to suck and swallow.

GENETICS

the branch of medicine that deals with heredity, the variation of individuals, prognosis for development and function, and risks of recurrence of genetic conditions.

HEART MURMUR

A rushing sound made by the blood within the heart, usually heard with a stethoscope. This may or may not be a sign of a problem for a baby.

HEELSTICK

A quick prick of the heel with a sterile instrument (much like a finger prick) to obtain small blood samples for tests.

HEMATOCRIT (crit)

A test done to determine if the amount of red blood cells in the blood is adequate.

HOUSESTAFF

a term referring to medical doctors who are enrolled in a supervised training program in an area of specialization, such as Pediatrics; see also INTERN and RESIDENT

HUMOR, SENSE OF

something you used to have before your baby was in the NICU. Don't lose your sense of humor, it helps parents get through these difficult times.

HYDROCEPHALUS

an abnormal accumulation of cerebrospinal fluid (the normal fluid which bathes the brain and spinal cord) in the ventricles of the brain.

HYPERALIMENTATION

see PARENTERAL NUTRITION

HYPERBILIRUBINEMIA

An elevated level of bilirubin in the blood. See JAUNDICE.

HYPOGLYCEMIA

A low amount of sugar (glucose) in the blood.

I:E RATIO

The ratio of the length of the forced breath provided by a ventilator to the length of the time between two breaths.

INFILTRATE (IV Inflitrate)

the slipping of an IV needle out of a vein, allowing IV fluid to accumulate in the surrounding tissues.

INTERN

a medical doctor in his or her first year of "residency." See also RESIDENT

INTRAVENOUS (IV)

A small plastic tube or hollow metal needle placed into one of the baby's veins, through which fluids, sugar, and minerals can be given when the baby cannot take all of his nourishment by feedings.

INSPIRATORY TIME (IT)

The length of a forced breath provided to the baby by a ventilator.

INTRAVENTRICULAR HEMORRHAGE (IVH)

A collection of blood in and around the ventricles (hollow portions) of the brain.

INTUBATION

Placing an endotracheal tube in the baby's trachea (windpipe). See Endotracheal Tube.

JAUNDICE

A yellow coloration of the skin and eyes caused by increased amounts of bilirubin in the blood. Bilirubin is a break-down product of red blood cells; it is processed and excreted by the liver. Treatments for jaundice include phototherapy ("bili-lights") and (rarely) exchange transfusion.

LUMBAR PUNCTURE ("Spinal Tap")

A procedure in which a small needle is placed in the small of the back, between the vertebrae (back bones), to obtain spinal fluid for bacterial cultures and other tests.

MAS (Meconium Aspiration Syndrome)

see MECONIUM ASPIRATION.

MECONIUM

The first bowel movements that a baby has which are thick, sticky, and dark green to black in color.

MECONIUM ASPIRATION

The inhalation of meconium into the lungs. If a baby passes meconium before delivery, the meconium may be inhaled into the lungs, causing problems with breathing after the baby is born. This condition is called meconium aspiration syndrome (MAS).

MENINGITIS

Infection of the fluid that cushions and surrounds the brain and spinal cord.

MRI (Magnetic Resonance Imaging)

A computerized method of viewing any portion of the body. It uses magnetism rather than x-rays. All metal must be removed from around the baby. The baby must go to another area of the hospital to have an MRI.

MURMUR

see HEART MURMUR.

NASAL CANNULA

A clear plastic tube which passes under the nose to provide supplemental oxygen.

NECROTIZING ENTEROCOLITIS (NEC)

An infection of the wall of the intestines, which may spread to the blood. Premature babies are particularly vulnerable to this disease. Surgery is sometimes necessary to remove damaged intestine, and the baby may need prolonged feeding by vein until he recovers. See also PARENTERAL NUTRITION, SEPSIS.

NEONATOLOGY

The medical specialty concerned with diseases of newborn infants (neonates). Neonatologists are pediatricians who have received several years of additional training.

NEPHROLOGY

A medical doctor who specializes in disorders of the kidneys.

NEUROLOGIST

A medical doctor who specializes in the brain and nervous system.

NPO

Nothing to be given by mouth.

OPHTHALMOLOGIST

A medical doctor who specializes in disorders of the eye.

OTOLARYNGOLOGIST

A medical doctor who specializes in the ear, nose, and throat.

OXYHOOD (02 hood)

A clear plastic hood placed over the baby's head through which oxygen is given.

PARENTERAL NUTRITION (also called Total Parenteral Nutrition, or TPN)

Protein and sometimes fats (lipids) given along with sugars and salts by vein when the baby cannot tolerate complete feedings by nipple or gavage.

PATENT DUCTUS ARTERIOSUS (PDA)

A small vessel which allows blood to bypass the lungs. This vessel is open while the baby is in the womb, but normally closes shortly after delivery. If the vessel fails to close on its own, special medication or surgery may be needed.

PEAK INSPIRATORY PRESSURE (PIP)

The highest pressure that is delivered to the baby by the ventilator during a forced breath.

PEDIATRICIAN

A medical doctor who specializes in infants and children.

PEEP

See POSITIVE END-EXPIRATORY PRESSURE.

PHOTOTHERAPY

A treatment in which the baby is placed under bright lights (frequently blue in color) or on a special light blanket which helps bilirubin to be excreted into the intestine. See also BILIRUBIN, JAUNDICE.

PICC LINE

see CENTRAL CATHETER

PIP

see PEAK INSPIRATORY PRESSURE.

PKU

A rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood. Babies with PKU require a special diet. All babies are routinely tested for PKU, as well as several other disorders, before going home from the nursery. This test is required by law.

PNEUMOMEDIASTINUM

Leakage of air from the normal passageways of the lung into the space surrounding the heart inside the chest. A pneumomediastinum is usually harmless in itself, but is often associated with a pneumothorax (which can be life-threatening if large). See PNEUMOTHORAX.

PNEUMOTHORAX

Leakage of air from the normal passageways of the lung into the space surrounding the lung inside the chest wall, causing a partial or complete collapse of the lung.

POSITIVE END-EXPIRATORY PRESSURE (PEEP)

The lowest pressure that is delivered by the ventilator to the baby between forced breaths. See also PEAK INSPIRATORY PRESSURE (PIP).

PROGNOSIS

What is expected in the future.

RED BLOOD CELLS

The cells in the blood which carry oxygen.

REFLUX

A return or backward flow; gastroesophageal (GE) reflux occurs when portions of feedings or other stomach contents flow back up into the esophagus.

REGIONAL CENTER

One of a network of state-funded agencies which helps to coordinate community services and resources to infants at risk of having a developmental delay; also provides services and coordination of resources to children and adults with specific developmental disabilities.

RESIDENT (Pediatric)

A medical doctor who is training to become a Pediatrician. A residency program is usually three years long. First year residents are sometimes referred to as interns. Third year residents are sometimes called senior residents.

RESPIRATORY DISTRESS SYNDROME (RDS)

A common breathing problem of premature infants caused by insufficient surfactant in the baby's lung. This results in an excessive stiffness of the baby's lungs. See also SURFACTANT

SEIZURE

A "short circuiting" of the electrical activity in the brain, sometimes causing involuntary muscle activity or stiffening. There are many causes of seizures. If your child has a seizure, speak with your baby's doctor about this condition and its implications.

SEPSIS

Infection of the blood. See also MENINGITIS, NECROTIZING ENTEROCOLITIS.

SEPTIC WORKUP

An assortment of tests performed on an infant who is suspected of having an infection. This may include a chest x-ray and/or abdominal x-ray, as well as blood, urine, and spinal fluid cultures. Because infections in babies can progress very rapidly, the baby is frequently started on antibiotics until the results of the cultures are known.

SUPRA-PUBIC TAP

Obtaining an uncontaminated sample of urine by first cleaning off the lower abdomen, then inserting a needle directly into the urinary bladder.

SURFACTANT

A material secreted by special cells within the alveoli (air sacs) of the lung, which makes the lung flexible and helps to keep the lung from collapsing. Deficiency of surfactant is the main problem in Respiratory Distress Syndrome (RDS). Commercial products are available which can be put into the lungs through the tube in the windpipe. These products frequently are very helpful to the premature baby with RDS.

TRACHEOSTOMY

A surgical opening in the trachea, below the larynx (voice box) to allow air to enter the lungs; usually done to by-pass a narrowing in the area immediately below the larynx.

TRANSFUSION

Giving donated blood to the baby by vein or artery.

ULTRASOUND OF THE HEAD

A test done using soundwaves which shows an image of the brain. The test is not harmful or painful to the baby and may be done at the bedside.

UMBILICAL CATHETER

A small plastic tube in one of the umbilical (belly button) blood vessels (either an artery or a vein).